Patient Satisfaction and treatment adherence Flashcards
What is patient satisfaction?
- Difference between perception of actual services vs expectations/ideals
- evaluation vs expectation
- satisfaction = specific to diff health experiences/events/hcps
What is patient satisfaction increasingly used as an indicator of?
Quality of health care
Why is it necessary to measure patient satisfaction? (hint: QAP)
- maintain and improve quality of care
- identify problem areas + reduce complaints
- assess impact on adherence to treatment
How can patient satisfaction be measured? (hint: SIFA)
- Surveys - self-administered, paper, computer
- Interviews - telephone, face-to-face
- Focus groups - particular group/service users
- Anecdotal evidence - thank you letters/complaints
What is the GP patient survey, who is it conducted by?
By Ipsos MORI - provides info to primary care managers, GPs + public about performance, access + choice of local services.
What is the National Patient Survey Programme and who is it organised by?
By Care Quality Commision - collects feedback from inpatients, outpatients, emergency care, maternity care, mental health services etc.
- used to track performance over time and measure progress against specific policies: overall measure of patient experience.
List and describe 9 factors that influence patient satisfaction
(hint: ccc haptid)
- Interpersonal skills of HCP
- Technical quality
- Convenience
- Availability
- Cost
- Physical environment
- Continuity
- Health outcome
- Demographics
What are consequences of dissatisfaction associated with?
- poor adherence to treatment
- changing dr/hospital - discontinuity
- using unorthodox treatment
- using OTC medications w/ prescribed meds - drug interactions
- poor health status - low perceived health, time off, red qual of life
What is patient adherence?
Extent to which patient’s action matches the agreed recommendations
What is the estimation for non-adherence to medication?
WHO - 30-50%
What are consequences of non-adherence?
- lack of improvement - deterioration
- increased hospitalisation
- increased morbidity + mortality
- increased GP visits
- more sick leave/days off school
- financial implications
- poor quality of life
What is the most common way of measuring adherence?
Self-report questionnaires or diaries (subjective) - used alone in 44% of studies, correlates with other measures but tendency towards over estimation.
What are objective measures of adherence?
- Physicians estimate - poorest correlation (0.2)
- Pill counts
- Physiological tests/markers - blood, urine, bp
- Health outcomes - bp, weight, body fat, cholesterol
- Mechanical devices - electronic pill counters/inhalers
- Direct observation - opa attendance, tb clinic
- Prescription refills - pharmacy monitoring
Why is non-adherence not seen as a patient’s problem?
It represents fundamental limitation in delivery of health care, often due to failure to fully agree to prescription in first place or to identify and provide support patients need later on.
Who is more likely to not adhere?
- Low education/income/socio-eco status
- Depression
- Lack of social support
- Complex regime
- Fewer symptoms, better perceived health status
